Calcium-Sensing Receptor Expression in Breast Cancer

Abstract

The calcium-sensing receptor (CaSR) plays a crucial role in maintaining the balance of calcium in the body. Altered signaling through the CaSR has been linked to the development of various tumors, such as colorectal and breast tumors. This retrospective study enrolled 79 patients who underwent surgical removal of invasive breast carcinoma of no special type (NST) to explore the expression of the CaSR in breast cancer. The patients were categorized based on age, tumor size, hormone receptor status, HER2 status, Ki-67 proliferation index, tumor grade, and TNM staging. Immunohistochemistry was conducted on core needle biopsy samples to assess CaSR expression. The results revealed a positive correlation between CaSR expression and tumor size, regardless of the tumor surrogate subtype (p = 0.001). The expression of ER exhibited a negative correlation with CaSR expression (p = 0.033). In contrast, a positive correlation was observed between CaSR expression and the presence of HER2 receptors (p = 0.002). Increased CaSR expression was significantly associated with lymph node involvement and the presence of distant metastasis (p = 0.001 and p = 0.038, respectively). CaSR values were significantly higher in the patients with increased Ki-67 (p = 0.042). Collectively, higher CaSR expression in breast cancer could suggest a poor prognosis and treatment outcome regardless of the breast cancer subtype.

Keywords: Ki-67 proliferation index; breast cancer; calcium-sensing receptor; estrogen receptor; progesterone receptor.

Figure 1

Immunohistochemical analysis of calcium-sensing receptor staining (CaSR) in breast cancer: (a) no expression (0), 20×; (b) rare positive cells (1), 20×; (c) non-uniform weak expression (2), 20×; (d) non-uniform weak/intense expression (3), 20×; (e) non-uniform intense expression (4), 20×; (f) strong uniform expression (5), 20×.

Figure 2

ROC analysis of CaSR values in breast cancer for assessing the biological aggressiveness of breast cancer based on the level of the Ki-67 proliferation index > 20.